SB 5904
In CommitteeSenate
Use of nursing titles
Concerning the use of nursing titles.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill clarifies and updates which nursing titles and abbreviations can legally be used only by licensed professionals in Washington. It replaces the term 'advanced registered nurse practitioner' with 'advanced practice registered nurse' and specifies that only licensed individuals may use associated titles and abbreviations.
- Prohibits unlicensed individuals or organizations from using titles like 'registered nurse', 'nurse', or 'R.N.'
- Allows only licensed registered nurses to use the titles 'registered nurse', 'nurse', and 'R.N.'
- Allows only licensed advanced practice registered nurses to use the titles 'advanced practice registered nurse', 'nurse practitioner', 'nurse', and abbreviations 'A.P.R.N.' and 'N.P.'
- Allows only licensed practical nurses to use the titles 'licensed practical nurse', 'nurse', and 'L.P.N.'
- Permits Christian Science nurses to use the title 'Christian Science nurse' as long as they do not imply they are licensed clinical nurses
Who is affected
- Nursing professionals — Must hold an active state or multistate license to legally use titles like 'registered nurse', 'nurse', or 'R.N.' and may not use them if unlicensed.
- Advanced practice nurses (e.g., nurse practitioners) — Must hold an active license to use titles like 'advanced practice registered nurse', 'nurse practitioner', 'nurse', or abbreviations 'A.P.R.N.' or 'N.P.'
- Licensed practical nurses — Must hold a license to use titles like 'licensed practical nurse', 'nurse', or 'L.P.N.' and may not use them if unlicensed.
- Christian Science nurses — May continue using the title 'Christian Science nurse' only if not claiming to be a licensed clinical nurse and not holding themselves out as such.
Pro/Con Analysis
Potential Benefits (5)
The bill strengthens protection against impersonation by unlicensed individuals, reducing risk of harm from unqualified personnel presenting as nurses — a major public safety concern, especially in home care, telehealth, and long-term care settings.
Public SafetyPeopleRef: Sec. 1(1), Sec. 2(1)By standardizing the title 'advanced practice registered nurse' (replacing 'advanced registered nurse practitioner') and restricting its use to licensed individuals, the bill improves clarity for patients and other providers about scope of practice, especially as NP-led care expands.
Public SafetyPeopleRef: Sec. 1(2), Sec. 2(2)The bill closes a potential loophole where unlicensed staff (e.g., medical assistants, health coaches, or wellness consultants) could use the term 'nurse' in marketing, thereby protecting vulnerable populations like seniors and chronically ill patients from deceptive practices.
Public SafetyPeopleRef: Sec. 1(3), Sec. 2(3)The bill preserves religious and cultural expression by allowing Christian Science nurses to retain their title, balancing credential integrity with constitutional protections for religious practice.
Rights & LibertiesPeopleRef: Sec. 1(4), Sec. 2(4)Healthcare employers (e.g., hospitals, clinics, home health agencies) benefit from clearer hiring and credentialing standards, reducing liability risk and improving workforce transparency — though small employers may face modest administrative costs.
Business & EmploymentLean peopleRef: Sec. 1(1), Sec. 2(1)
Potential Concerns (5)
The bill may reduce consumer confusion and prevent unlicensed individuals from misleading patients into believing they are licensed nurses, thereby improving patient safety and trust in healthcare providers.
Public SafetyPeopleRef: Sec. 1(1), Sec. 2(1)The bill explicitly preserves the right of Christian Science nurses to use their traditional title, provided they do not misrepresent their credentials, protecting religious expression and cultural identity while preventing credential confusion.
Rights & LibertiesPeopleRef: Sec. 1(4), Sec. 2(4)By restricting use of titles like 'nurse practitioner' and 'A.P.R.N.' to licensed individuals only, the bill strengthens accountability and clarity in healthcare provider identification, reducing risk of misattribution of care responsibilities.
Public SafetyPeopleRef: Sec. 1(2), Sec. 2(2)The bill prevents unlicensed individuals (e.g., untrained personnel in clinics, wellness centers, or telehealth platforms) from using titles like 'L.P.N.' or 'nurse', which could mislead patients about the scope and safety of services offered.
Public SafetyPeopleRef: Sec. 1(3), Sec. 2(3)The bill may increase compliance costs for small healthcare businesses and staffing agencies that currently use ambiguous titles (e.g., 'nurse coordinator' or 'clinical nurse specialist' without licensure), requiring rebranding and staff retraining.
Business & EmploymentLean peopleRef: Sec. 1(1), Sec. 2(1)
Who Is Most Affected
Licensed nurses (RNs, NPs, LPNs) benefit significantly — the bill reinforces the value and exclusivity of their credentials, enhances public trust in their titles, and reduces unfair competition from unlicensed individuals using similar titles.
Patients and consumers benefit from greater transparency and reduced risk of receiving care from unlicensed personnel posing as nurses — especially critical in home health, telehealth, and senior care settings.
Christian Science nurses retain their traditional title under strict conditions (no implication of clinical licensure), preserving religious identity while aligning with consumer protection goals.
Unlicensed personnel (e.g., health coaches, medical assistants, wellness consultants) who currently use 'nurse' in titles may need to rebrand, potentially incurring costs and limiting marketing flexibility — though this reduces consumer deception.
Healthcare employers benefit from clearer hiring standards and reduced liability exposure, but may face short-term costs in updating job postings, contracts, and staff credentials to comply.